Monday, December 30, 2019

Weeks 9 & 10 - Two more weeks, Check

Weeks 9 & 10 - Post Lemtrada

December 29, 2019

These last two weeks were a combination of whizzing by and no motivation.  I stayed busy getting ready for Christmas, getting ready for more care giving activities, playing caregiver again and Christmas Day.  Our Christmas Day was nice and quiet though. 

I did get my blood results or at least most of them.  I did not get the Lymphocyte Subset so I don't know where my T & B cells are specifically but my total Lymphocytes actually went down a little bit.  It's pretty disappointing.  The only comment I got from my Neurology office was "blood results are within range".  I sent them a note asking if they were concerned at all that my Lymphocyte levels didn't go up at all, if they were still expecting my other blood results and what their suggestion is for my interaction with crowds but I haven't gotten a response back yet.  I sent a follow-up yesterday but nothing today either.  It is the holidays but like I said in my note to them, I can't hide away from the world forever.  I posted my results under Pages if anyone is interested.

My emotions have been a bit of a roller coaster the last two weeks.  The Lymphocyte levels are really disappointing.  I've been trying to not get down about it but it's really hard.  I keep telling myself it's only been two months but the doubts pop-up easily when you haven't seen anything positive to point at.  Then it starts feeling like everything else that you've tried (just another dart).  On Saturday, I was getting really anxious about my to-do list (this blog being a week behind being one item). The list really isn't that long and that made me feel worse because I was upset with myself for not being able to handle things like a normal person.

I've also had some stomach issues over the last week and a half.  Last week it was just a little queasy feeling and had some gas pain.  Yesterday, I had some bad stomach cramps for part of the day.  It felt like my actual stomach lining was cramping and I felt hungry and nauseous at the same time.  I had gastritis over 5 years ago and it was the same type of feeling.  I think it's from all the antibiotics I've been taking.  From it irritating my stomach and from the lack of good bugs in my gut.  I have been taking a pro-biotic here and there; I haven't had anymore issues with that so far.  I also took a Nexium yesterday because I remember taking an antacid was one of the things I did when I had gastritis.  I exchanged a few text messages with my PCP today.  She agreed with me that it's probably from the antibiotics and told me to keep taking the Nexium or take some Prilosec.  Today my stomach has been better not 100% but nothing like yesterday.

That's it...a blend of legitimate busy-ness, being in my head and stomach stuff.  Sorry for being such a downer again this week.
I hope everyone had a good holiday week and Happy New Year!

Sunday, December 15, 2019

Week 8 - Keep on Truck'in

Week 8 - Post Lemtrada


December 15, 2019


When I started doing the weekly posts, I was typing daily notes to myself about all the things that went on that day.  I've gotten away from that so now when I get to these, I have to think "what happened this week". 🤔 This week was really about keeping myself/things moving forward; helping my husband; taking care of the 'chores' around the house (laundry, grocery pick-up, picking up and dropping off kids, etc, etc, etc); and taking care of Christmas gifts online (I am not going anywhere near a mall or Target). Or into a post office which is unfortunate because I do like to wrap gifts myself and send them to my nephews.

That was the main thing for this week; just getting through all the day to day and holiday stuff that doesn't wait.  Every week, I need to make decisions on what errands I think I can run and be ok and which ones might be a little more risky (interaction with a larger number of people).  I feel like if it's a situation where I can tell if someone is sick and avoid them then I am safer than if I am just in a crowded store where you are walking by a lot of people and don't have time to assess who is sick and who isn't.

I took the last of the Macrobid on Tuesday this week and haven't had any additional bladder or UTI symptoms.  My sleeping and energy level has been the same, day-to-day, not any worse or better overall. I have been staying up a little later than I should some nights so that hasn't helped.  I am due to get my monthly blood and urine test this week.  Yesterday, was officially eight weeks so I may see my T & B cells coming back in these results.

It doesn't feel like it's been two months.  Time actually went by kind of fast.  I think because I thought I would have all this extra time but unfortunately I really haven't.  I was thinking the other day that it's been two months since I've been to a restaurant.  Honestly, it's not even something I miss.  We've gotten carry-out so I don't know if that helps or not.  What I am really looking forward to is not having to think so hard about what I am eating or where I am going.  I hate grocery shopping but it'll be nice when I can just run to the store and not have to think strategically about whether I really need something or if someone can go for me instead or when the least busy time is so I can run in and out.  I am tired of missing out on events like school concerts and local plays that we had tickets for.  Getting back to more normalcy will be nice.

Have a good week.

Thursday, December 12, 2019

Week 7 - damn bladder infection

Week 7 - Post Lemtrada

December 8, 2019


I guess we are getting to the very boring part of this journey.  For myself, there is not too much going on.  In life, things are never dull.  As I mentioned at the end of my last post, my bladder infection was stubborn.  I went to the Doctor's on Monday, they sent off a urine sample for a culture and gave me that crazy antibiotic.  On Wednesday, they called and based on my culture results switch me to a Macrobid.  I was more then happy to get off the crazy antibiotic.  The Macrobid did the job; I am feeling better.

I saw my Dermatologist this week too.  Because of my family history of skin cancer and because I had a melanoma 3 years ago, I will be seeing her every 6 months for a couple of years.  She didn't see anything concerning but I did have a mole that was moderately atypical and it was coming back so they took another biopsy.  She didn't think it looked like anything but wanted to be sure.  After I got home, I realized that I really should have waited until my next appointment in 6 months to have the biopsy.  Especially since she was just taking it as a precaution.  My PA had just suggested I postpone my dental cleaning a couple months instead of opening myself up to possible infection then I go and get a skin biopsy.  Not too smart on my part. 🙄 In 6 months, I'll be better able to heal and fight off infection.  I wasn't happy with myself for not thinking about that.  The biopsy results came back normal so all is good there.

My husband had arthroscopic surgery on his shoulder so that's kept me busy; taking care of him the first couple of days and just helping him out this week.  In a week and a half my son is having surgery.  I'll be playing caregiver again.

My energy level and sleeping has been the same.  Some nights I sleep better than others and some days my energy is a little better than others.  There has been times when I just don't have any motivation to get off the couch but I haven't had any days when it's just impossible to get moving.  I had read that some people do have fatigue that is that bad.

I mentioned in my "First Follow-up" post that I had talked to my PA about seeing a functional medicine doctor about hormone issues.  I have an appointment with one in January.  I am cautiously optimistic.  I've tried so many different things throughout the years that I start to feel like I am throwing darts at a wall.  Most things I've tried have helped a little but I've never found the magic combination.

Saturday is the official 8-week point.  My T & B cells should be starting to repopulate.  I am wondering if I'll feel any different or notice at all.
Until next week...

Tuesday, December 3, 2019

Week 6 - Thanksgiving of sorts

Week 6 - Post Lemtrada


Nov 24-30, 2019

I hope everyone had a good Thanksgiving holiday.  This week's post is late and I have a reason.  I've been very emotional this week and I feel like all I am going to do in this post is complain and I don't feel comfortable doing that especially since I feel like most of my posts lately have been full of complaining.  I grew up in the Midwest and that's not something we do.  Let me qualify that;  people from the Midwest do bitch, sometimes.  We bitch about the weather, our boss, the traffic and lazy corrupt politicians but we do not whine.  There is a difference: A. even though we bitch, we put our head down, scrap off the car and go to work (there are bills to pay and kids to feed). B. whining is done is an annoying voice. 😏 You can not hear my voice but I think I am moving more into whining territory. 😔 Plus we don't talk about our feelings and I've been feeling pretty miserable.  There you go; another post of complaining and about feelings and I freeze up.

The first couple of weeks I was going back and re-reading my posts and correcting for grammar, etc.  I haven't read any of my last four or five posts because they are just embarrassing.  I want people who are or may be in the near future going through this process to know that these annoying things can happen and maybe they are little in the grand scheme of things but they can happen and still make you miserable for a bit.  Putting this out there at all is uncomfortable for me but it is much easier to write about how great you feel and how great everything is going then how down in the dumps you feel.

On Monday night, I felt slightly like there might be a bladder infection coming on.  By Tuesday afternoon, there was no doubt and it hit me hard.  I was running to the bathroom every 5 to 10 minutes and had all the other text book bladder infection symptoms; no fever though.  I upped the amount of D-mannose I was taking, took a cranberry concentrate and drank some cranberry juice.   That definitely took the edge off within an hour.  There is some disagreement about whether cranberry really helps a bladder infection; I am not sure if it will cure one but I have found that it makes the symptoms more tolerable faster then an antibiotic by itself.   I  contacted my Neurology office and my PCP.  My PCP got back with me first.  She was going to prescribe a Marcobib but when I told her I was already taking Sulfameth/Trimeth (Bactrim) once a day, she suggested upping it to twice a day because it's an antibiotic typically used for bladder infections.  She said for 5 days.  My Neurology office was good with that and also suggested I keep taking the cranberry concentrate (I wasn't taking it every night) and take a 1 tbsp shot of apple cider vinegar.  It's supposed to lower your pH and make it harder for bacteria to grow.  I also kept taking the D-mannose and upping my water intake.  I forgot to do the apple cider vinegar shots except on Saturday and Sunday nights but I did everything else and the bladder infection never fully went away.  As I am sure you can imagine with the extra water and my bladder not behaving in general, I was up once or twice a night to use the bathroom so sleeping was not great this week either.

And because it seemed like a good idea in August when I scheduled it, my son got all four of his wisdom teeth out on Tuesday as well (my husband took him).  Then my husband and daughter left on Wednesday to visit family for Thanksgiving.  I didn't want to risk flying and I didn't want them to stay home because of me.  My plan was to hang out with my son, eat soft foods and binge on Netflix, which we did.  There was just this underlying 'not great' feeling for me and I was a little out of it too.  I even forgot to get the mail all week. 🙊  And my homemade gluten free version of the family roll recipe came out too dry so that was a big thanksgiving soft food feast disappointment.  Sidebar: Did you know that there is a British version of Design Star?  It's called Interior Design Masters and instead of their own TV show, they win a commercial design contract.  We watched the whole first season.  Wasn't too bad, at least they had cool accents.  

That brings me to just being tired of being tired and of not feeling good.  I know that this journey has just started but anyone who has had MS for a while and who's main symptom is fatigue knows what I am talking about.  It's a general feeling, you can't see it, you pretend that everything is fine but really you're not and you just hate feeling this way.  The feeling really hits me when it feels like it's one thing after another.  First it was the steroids keeping me up then I had the cut/irritation on the inside of my cheek, now I have a bladder infection that doesn't want to go away.  Is any of that a big deal?  Of course not; there are way worse things in the world but when you are sitting around the house looking at all the piles and projects that you would like to be doing but don't have the energy or concentration for, it gets to you.

I am on a new antibiotic called Ciprofloxacin and they are doing a urine culture which might be back tomorrow or Thursday.  I can't tell if the antibiotic is working but I think so. 🤞 This antibiotic has almost as many possible side effects as the Lemtrada.  I have to drink extra water because it might affect my liver.  I can't eat or drink dairy with the medication because it might cause tendon issues; I can't drink caffeine; I can't take certain vitamins like calcium, iron, zinc or magnesium too close to the time I take the antibiotic and it might cause nerve issues...I wish I was joking...it's just slightly crazy.

Here's to hoping the antibiotic works and doesn't kill me. 🍷

Sunday, November 24, 2019

Week 5 - Quiet, finally!

Week 5 - Post Lemtrada

November 24, 2019

This week for the most part was quiet and boring...finally!!!  I started sleeping through the night toward the end of the week too.  I am still pretty low energy and fatigued but it is such a relief to be sleeping better.  Being low energy and fatigued is actually nothing new for me and I probably wouldn't even have noticed if I hadn't had a taste of what it's like to be high energy and in a good mood with the steroids.  

I kept myself entertained this week by reading "Where the Crawdads Sing", good book; I've been cooking quite a bit and I've been researching functional medicine doctors. My daughter's birthday was on Friday (I have a 17-year old now!!! 😱).  We broke with family tradition, had her birthday dinner at home and she picked what we made.  I made a gluten free birthday cake for her.  King Arthur's gluten free yellow cake mix is pretty good.

I got the results of the missing blood tests and they were all within expected range.

Not much to write about.  I didn't have any issues this week; no chills or aches.  The only thing new is that my skin is really dry and flaky which is typical for this time of year when the furnace starts running but it's worse then normal.  It seems like I am shedding a whole layer of skin at once like I am molting. 😳 A couple of weeks ago the same thing happened with my scalp.  It was one big flake. 😝  Like with the inside of my cheek last week, it makes me wonder "are any of the medications making it worse?".  Not that it's really a big deal; just something that's going on.

Well, that's really all I have.  I hope everyone enjoys their Thanksgiving holiday.

Tuesday, November 19, 2019

First Follow-up

First Neurology Follow-up Post Lemtrada

November 18, 2019

My first follow-up with the Neurology Clinic was uneventful.  My T & B cells are below detection limits which means I have no immune system and the Lemtrada did it's job.  The PA said we would start to see them come back around the 8-week mark and that I should continue to be vigilant about staying away from anyone who is sick (my daughter has a cold right now 😞) and staying away from crowds.  I asked her about different appointments and going out in general and she said she would advise if it's something I don't have to do, not risk it.

The lab didn't get all the tests they needed so I have to go back in.  The main one there is how my thyroid is doing.  I take a low dose of Amour Thyroid now so they my adjust that depending on the results.  They also check to make sure the Lemtrada isn't giving me Thyroid disease which is a possible side effect.

We talked about the process when my T & B cells start coming back.  Sometimes the B cells start to repopulate faster then the T cells and if that happens they will give me a medication to knock the B cells back a bit.  I've been reading more blogs and message board comments from other Lemtrada patients and it seems like people note issues around 7 months.  Either suddenly not feeling good or getting new relapses.  I asked if this was because of the T & B cells repopulating at different rates.  She said it's actually done to prevent additional autoimmune complications like the thyroid issue.

We also talked about the problem I had with the probiotic and she recommended just not taking one right now.  I have been adding dairy free yogurt to my occasional smoothie and haven't had an issue with that.  I asked about how vigilant I should be with wearing sunscreen given my family has a history of skin cancer and I've had one spot myself.  She recommended using it everyday especially on the most exposed areas.  I use mineral foundation which has some SPF qualities but I think I am going to get a moisturizer with it as well.  I'll need to start thinking about my hands too since they are always exposed.  

The last thing we talked about was how the Solu-Medrol affected my mood for the better and what that means.  My husband had been doing some online research and found that Solu-Medrol has an effect on cortisol levels which affects your mood, energy level and also makes sleeping difficult.  We had talked about my going to see a function medicine doctor about hormones in general before and she suggested that maybe this is something they could look at as well.  She also said that the first two month are the hardest due to dips in energy level and just overall how you feel.  So something to look forward to in the next 4 weeks. 😉

That was it.  I'll post a page with some of my blood results if you are really interested and will post again on Sunday.

Sunday, November 17, 2019

Week 4 - A Rough One

Week 4 - Post Lemtrada

November 17, 2019

This was a rough week; some things maybe made worse by the Lemtrada added to the continued sleep deprivation made me zombie-like.  I am at the very end of my Invisalign treatment. I switched out to my very last tray last week, Thursday.  By Saturday, the inside of my left cheek was really irritated; I thought I had bit the inside of my cheek overnight but it kept getting worse and on Sunday I realized it had to be the tray.  I switched back to the previous tray but it took all week for it to heal.  Yesterday, was the first day that I could eat without first numbing the area with Orajel.  That's how bad it was.  It hurt to eat and it hurt to sleep on my left side (my usual position) and rest my cheek on the pillow.  Sleeping on my right side made my right shoulder hurt; I was a disaster this week and I felt like it. 

The worst days were Wednesday and Thursday; I feel like I was holding it together until then.  On Wednesday, I just hit a wall and I also got the chills and started feeling achy around dinner time.  I did check and my temperature was normal.  I took some Tylenol and felt fine the next morning.  This happened on Thursday and Friday evening too.  My temperature was a degree above my normal on Thursday night but I never ran a fever.  Both of these times, two Tylenol was all it took and I was fine in the morning.  My cheek had healed up enough by Thursday night that I could sleep mostly normally, I got a pretty good amount of sleep on Thursday and Friday nights so I felt a little more like myself on Friday.

I was told by one of the nurses at the infusion center that it would take me longer to heal and suggested I use antibiotic ointment on cuts.  Apparently, it also makes you more sensitive to irritation too.  I've been doing Invisalign for just over a year.  I've had trays that irritated my mouth before but not like this.  I checked the tray and didn't see anything obvious that would have caused that.  It also seemed to take longer to heal then it should have.

The energy dips are to be expected but is made worse by not getting enough sleep.  I need to find a balance when they happen.  I tend to do the basic "mom" things that I need to do when they happen and I don't do the "taking care of myself" things.  I barely did any yoga, I wasn't making myself celery juice or smoothies, I wasn't drinking as much water (although I wasn't dehydrated), I wasn't writing in my journal and I wasn't even getting in the shower everyday.  Clearly, some of those things I need for my physical and mental health.  My mind goes to "what do I have to do" to get through this day and unfortunately, those things don't make the have-to list.

My relapse seems to have mostly passed.  I noticed on Friday morning that my legs were back to normal; that could have happened sooner but I didn't notice.  My finger tips are still a little bit numb. I did some reading and it is common for old relapses to come up.  It's the new ones that they look for to track progress.  Also, this is the first of a two step treatment so it wouldn't be unheard of to have new progression this year but it is hoped that it is slowed down.

I had my blood drawn on Friday.  I'll get results tomorrow (Monday).  I'll do a quick update on how that goes.  Some people post their blood results.  I don't know why anyone would really care but maybe I'll post it as a 'page' in case anyone really wants to see the numbers.

Monday, November 11, 2019

Week 3 - The Big Crash

Week 3 - Post Lemtrada

November 10, 2019

We knew it was coming and it's here...the Big Steroid Crash.  I could tell it was coming last weekend. My energy level had been dropping throughout the week and by last weekend it was pretty low.  I still wasn't sleeping well and with the steroids wearing off, I had nothing to boost my energy and get me through the day.  I was tired all day on Sunday of last week.  On Monday I worked outside a little bit, I spray cleaned some of the windows on the house (in the back and side of the house), by the time I came in and took a shower, I was completely drained that was all I had in me.  By Tuesday, I could tell my mood was down in the dumps with my energy level.  It's kind of depressing itself;  I was getting used to being in a better mood.  I was easily irritated this week too.  I got mad at my husband for sitting in the recliner because I had been sitting there (before he came home) and I was pissed off on Tuesday when I had two people ring the door bell while I was doing my therapist session.  I only had something going on for 1-50 minute block of time all day and folks chose that time to come ring my doorbell plus the dog was whining to go out then to come back in.  It was also annoying me that I was starting out the week doing a bunch of shit I didn't want to be doing.  I had planned to be bored and take care of things I've been meaning to do around the house and it's just been a parade of people coming through the house the last two weeks to fix things.  I just want to yell "leave me alone!".  On Wednesday, I burned some sage. 💆🕯

My sleep still hasn't gone back to normal which is not helping my mood/irritation level.  I stopped taking the Tryptophan; Monday night was the last time I took any kind of sleep aid except for Friday night (I took it at 2am because I wasn't able to fall asleep).  Except for Friday night, I've been falling asleep pretty quickly but I still generally wake up in the middle of the night to go to the bathroom and have been waking up early.  Some mornings earlier then others.  Because I don't have the steroids in my system anymore to boost my energy level, I've been dragging during the day.  I ended up taking a 3-hour nap on Friday; I was still tired so I didn't think I would have trouble falling asleep at night but I did.  That's why I ended up taking the Tryptophan; I fell asleep within 30 minutes after I took it.  By Saturday night, I was drained completely...it was either the lack of good sleep all week and/or the turkey we had for dinner but I passed out on the couch around 8:30.  I slept until 11 and was kind of awake for about an hour before I headed to bed.  I slept until 6:30, used the bathroom, went back to sleep and struggled to open my eyes at 8.  I slept over 10 hours and still struggled to open my eyes.  I think this is my crash #2 where my body finally starts catching up on the sleep I lost.  

I started taking my Vyvanse again on Sunday.  I had been thinking about it for a few days and when I got up on Sunday still so tired; I decided it was time.  It definitely helped get me through the day and boosted my mood a bit as well.

The other thing going on is a relapse.  On Tuesday morning, I got up in the middle of the night and had to stop for about 30 seconds before my legs wanted to go again.  The technical term is spasticity but I call it bouncy.  How it shows up for me is that when I first get up in the morning, I need to pause while my legs bounce under me for a bit then I go about my day.  It's only ever first thing in the morning.  I think it started sometime in 2016; I also always get finger tip numbness along with my legs.  The finger tip numbness started in mid-2014; we actually thought it might be carpal tunnel.  My neurologist had me wear a wrist brace for a bit.  Obviously, at some point I realized it was coming and going.  I started a symptom tracker spreadsheet in 2013 but I am not always good at recording everything especially when it's a 'same 'ol relapse'.  They kind of come and go and you don't notice as much.  Lately, the bouncy legs and numb fingertips have been a precursor to numbness or some other relapse.  So far nothing else has shown up and I don't have that buzzy feeling in my spine when I stretch my chin to my chest.  That is usually another sign that something is coming on.  It's a little disappointing that I am having a relapse so soon post-Lemtrada especially after being on so many steroids.  Tuesday morning was the worst of it though.  It made me realize I had been having that sensation for a few days before and since then I've had it every morning but more mildly.  The finger tip numbness has been pretty constant.    

I've been doing what I can to take better care of myself.  I had a good virtual private yoga session with my yoga teacher this week.  We worked on building a practice that will promote healing of my lower back and support my MS.  I've been trying to do my practice every morning.  Some days, I just get up and go or I lay back down for a while and by the end of the day I still haven't gotten to it.  That's my typical MO and I think most moms could say the same; we put everything as a higher priority then taking care of ourselves. I started making smoothies again, making sure that I wash or rinse everything including the frozen berries.  I also started making/drinking celery juice. Again, making sure everything is cleaned first.  Celery juice first thing in the morning on an empty stomach is really good for you.  The natural salts help to balance your pH and your stomach acid, it's hydrating and flushes toxins.  The first couple weeks after my infusion, I just wasn't sure what to eat and was being overly careful.  This week, I am still being careful but have loosened up a bit.  I need more fruits and vegetables in my diet if I want to stay healthy. Before my infusion, I bought myself some locally made bone broth.  It's also very healing and I wanted to drink it in the mornings especially since I am not able to have herbal tea right now.  I used to buy it occasionally but buying it more regularly gets expensive fast so I bought myself an Instant Pot and I am going to make it myself.  I made chicken noodle soup with a whole  chicken on Saturday and it turned out great.  I am going to try making the bone broth next week.

I am up way too late so this is going to be all for this week.
P.S. - I will be going to the lab next week for the first of my monthly lab work and I'll get results at my neurology visit on the 18th.
P.P.S - This will be my last format change. 😉

My Basic Smoothie Recipe:
1.5 cups frozen mixed berries
1 cup coconut water
1 small container dairy free yogurt (I usually use coconut milk plain or vanilla)
0.5 of an avocado
a handful of baby spinach
1 tsp of Dulse flakes or the contents of one Kelp capsule
~ a tbsp of honey (not using honey at the moment due to potential bacteria)

Instructions for bone broth that my friend forwarded to me:
https://40aprons.com/instant-pot-bone-broth-gels-whole30/#wprm-recipe-container-13917

Recipe for the Chicken Noodle Soup I made:
https://recipes.instantpot.com/recipe/chicken-noodle-soup/

Sunday, November 3, 2019

Week 2 - Waiting for the Steroid Crash

Week 2 - Post Lemtrada

November 3, 2019

HAPPY HALLOWEEN!

Sorry to those anxiously awaiting my next post. ;). I was planning to post tonight but I am really tired.  I can definitely tell the steroids are finally wearing off.  I've been very tired all day today.  I've had no major symptoms this week; just more of the same trouble sleeping.  I'll post more tomorrow, I promise.

-UPDATE-

In my last post, I mentioned that this past week was busy.  It was busy because things kept breaking the week before.  I say breaking but it was just an odd week. First a woodpecker decided there was something good to eat in our chimney and pecked a hole in the siding.  So I had a pest control person out to look at the chimney/ spray it with insect spray.  Then the garbage disposal that we just had installed last month started making a lot of noise so the plumber was out to replace it.  I also had brackets on our shower glass replaced, we need to get trees trimmed so that contractor was out to take a look and our pool company plugged our solar heat system so I spent way too much time on the phone for that and the pool maintenance company and solar company were out to fix it. 😟  It was that type of week, lots of people in and out which made me a little uncomfortable.  I felt like I was exposing myself to too many people but I also told everyone that I was on an immune suppressing medication, needed to keep my distance and I did.

It's a good thing I still had plenty of energy earlier in the week. I could have been irritated by all the things going wrong and by my lack of sleep on top of it but I just floated happily through the week.  The steroids are still slowly wearing off and my sleep or lack of continues to be my biggest issue.   I went back to 1/2 an ambien on Sunday night after the whole one effected me so much.  That went the same, fell asleep quickly but was up really early.  On Monday night, I decided not to take an ambien to see if I could fall asleep without it.  Not a great idea; I was up until 3:30 and woke up at 6:30. I spoke to one of the neurologist in the Clinic.  He suggested I go two more nights with the ambien and then we would assess if I should add in some supplements.  Tuesday night I took about 3/4 of the ambien, I fell asleep fast around 10:30 and slept until my alarm went off at 6:40.  It was an amazing 8ish hours of solid sleep.  The next night, I was right back to my usual waking up in the middle of the night for a bathroom trip and waking up at 5:30.  I sent a message to my neurologists letting them know the sleep aid was still helping me fall asleep but not keeping me asleep.  They recommended adding in 1000-1500 mg of L-Tryptophan.  The PA had recommended starting at 500 and going up in 500mg increments. That's what I did but I stayed at 1000mg.  I took both the L-Tryptophan and Ambien on Friday night then only the L-Tryptophan on Saturday night.  Slept the same; fell asleep fine was up once in the middle of the night then early in the morning.  As I made my way to the end of the week, I could feel my energy level draining a bit.  I was feeling the lack of sleep more and more.  On Thursday, my energy just crashed around 3:30 and I ended up taking a nap.

Another thing I talked with my neurologist about was my feeling like a hypochondriac, he told me not to feel like that that they want me to over report. That made me feel a little better.  I'll just let them decide if it's something to worry about.  I also found out that I don't need to drink extra water; I just need to make sure I am hydrated.  I am not very good about that so even drinking the normal amount of water that you should be drinking anyway; makes extra bathroom trips for me.

I spoke with my One-to-One nurse this week as well.  I was asking her about dairy free yogurt; it's hard to know what is at risk for Listeria and what isn't.  She mentioned that the FDA keeps a current recall/advisory list for food contamination (link).  You can search the list for Listeria.  That's very helpful.  She also recommend doing the self symptom checks monthly on the day you go for your lab/blood work.  That was a good suggestion because I thought you needed to do those checks more often.

I got a recommendation to use D-Mannose to help prevent bladder infections.  I asked my neurologist's office about it and they said it has been shown to prevent bladder infections and recommended taking 500mg every other day or so. I get bladder infections frequently; it is something we need to keep an eye on.

I worked outside a bit this week; pulling weeds and digging up and moving a drip line. I made sure I put sunscreen on and as I was walking out the door, I remembered how my husband got a staph infection on his knee after we were working outside a couple years ago.  I grabbed some disposable gloves.  While I was outside, I realized I should have also put on some mosquito repellent.  I didn't get any bites, luckily.  Usually, I am a mosquito magnet.  It was nice to get outside and get some sun.

That was my Week 2. Week 3 will be interesting; the steroids will officially be out of my system.  We will see how that effects my mood and energy levels.  Hopefully, it will also mean that I can sleep better...until then.
  

Sunday, October 27, 2019

Week 1 - Now Featuring an Update

Week 1 - Post Lemtrada 

October 27, 2019

You might have noticed I am messing around with the Blog format; I am trying to find a 'theme' I like.  This is going to be super quick because it's already 10 and I am beat but I said I would post once a week on Sunday.  It's been suggested that I make that twice a week.

This week the worst symptoms have been related to the steroids.  The steroids have really taken me for a roller coaster ride of hot flashes, bursts of energy, trouble sleeping and short tempers.  I could tell by Thursday that they were starting to wear off because the sweating was subsiding.  I have been feeling good other than that.  The flu like symptoms I was expecting did show up twice this week.  I felt feverish (but my temperature was normal); my face felt flush, lips dry, slight headache and my neck felt achy.  I took one Advil and it went away.  So pretty lucky so far *knock on wood*.  If I could just get some consistent sleep, I would be golden.  Oh and by the way, I found out this week that Melatonin is also involved in ovulation, menstrual cycle and menopause (google: period and melatonin).  I took it for a week and surprise! my monthly friend arrived a week early.  FYI - ladies!😳
The irritation on my scalp went away. 🤷
This post...to be continued.

-UPDATE -

Last week was mundane and went by so slowly; this week was busy and that's why I am updating this four days later.  The good thing about last week, though was by Tuesday, we realized my daughter and husband had allergies not a cold.  Their symptoms were either gone or going away and they never got congested.  It was a huge relief for all of us.  I had been keeping my interactions with my family to a minimum which is hard anyway but I had also just finished doing my infusions which was huge. I wanted to celebrate making it through and I couldn't. 😞 It's also hard to ride that fine line between cautious and obsessive when you walk into the kitchen and think "Everything in here might be contaminated". There were lots of Seventh Generation Disinfecting Wipes used last week. 😊 My husband slept in the guest room another couple of nights because I was so uncomfortable at night and still waking up so often.

This is me on the other side of the fine line. 😉

As I mentioned in my quick post, steroid side effects have been my worst symptom.  The week of my infusion I was already having trouble sleeping and as I also mentioned before my neurologist's office recommended Melatonin. It helped me fall asleep but it didn't help me stay asleep and then when it affected my menstrual cycle, I stopped taking it.  I spoke to the PA in their office and she recommended two other supplements L-tryptophan and GABA (Gamma-aminobutyric acid) but also prescribed me two weeks of Ambien.  I started taking 1/2 on Thursday night; that first night I slept 8 hours, straight; no bathroom trips!  On Friday night, it was the same as with the Melatonin; I fell asleep quickly but I woke up once around 2 or 3am to  use the bathroom then at 5:30 I was wide awake.  Five Thirty seems to be my witching hour; I am just awake and can't fall back asleep almost every morning.  On Saturday night, I tried a whole pill to see if it would help me sleep through the night.  It did, kind of, I was awake again at 5:30 but I drifted in and out of sleep for another two hours then after I ate breakfast, I went back to bed and slept another two hours!  I felt "zoned out" until about 3pm.  Clearly, a whole pill is too much for me.

Even though my sleep isn't consistent and I am not sleeping enough, my energy has been pretty high especially in comparison to what I should be in my sleep deprived state.  Some days I was sleepier then others but overall my energy has been higher than my "normal".  On Tuesday specifically, I felt like I was on speed.  It was crazy!  This was Tuesday of last week so that was 3 days after my last steroid infusion.  I was talking fast and couldn't sit still.  I did a Zoom session with my therapist that day.  I am usually a pretty reserved person and sometimes I don't know what to say during these sessions. I talked the whole 50 minutes and I talked so fast that I am not even sure she caught everything I said! I woke up at my typical 5:30 that morning and I was still wired at midnight.  I did make myself sit down and watch some TV because I was afraid I was going to crash or wear myself out. That was also my worst day for sweating.  Over Monday night, I kept waking up in a cold sweat and I said multiple times that day, I was a walking hot flash.  It was horrible, really. By Thursday, the hot flashes and the night sweats were gone but I could tell I was still running hotter then normal because I am usually cold.

The other thing affected by the steroids has been my mood.  Overall, I am in a good mood more consistently then my typical.  I've noticed that I can get a little snippy but I am also a lot more talkative in general and I am not holding back like I normally do.  I am joking more and smiling more.  I talked to one of the neurologists in the office this week.  He told me that the steroids could take 7-15 days depending on the person to wear off.  I never would have guessed it could take up to two weeks for them to wear off.  I am ready to sleep better but I really hope that my better mood stays.  Fatigue and depression are very common symptoms of MS.  In my therapy sessions, we've often talked about how much of my fatigue and depression (I don't call it depression because I usually don't feel sad; most of the time I just feel blah) is related to my MS and how much is related to just life circumstances or things in the past.  With my mood elevated by the steroids, we talked this week about how this seems to be a sign that the majority of this may be related to my MS.  Whatever is the cause, I've gotten a taste of what it feels like to be in a consistent good mood and I don't want that to change.

And with that thought, I really need to get to bed.

Monday, October 21, 2019

Post Lemtrada Day 2 - ProBiotic Fairy

Post Lemtrada Day 2

October 21, 2019

Pro Tip: Do Not take a probiotic immediately before you hop into bed.

It is possible that it might cause you heartburn, fill your stomach like a balloon and cause you to not sleep all night...hypothetically...🙈

I thought I would do a quick update tonight since I mentioned I was planning to call my neurologist's office.  I call them this morning. They agreed that the slightly sore throat was probably just allergy/drainage.  Last night a front went through so my nose was running a little bit more today; but my throat feels better.  

I noticed last night that I have some irritation on my scalp.  I am not sure how to describe it better then that.  I have little red patches; they are not bumps and it doesn't hurt (sharp) as much as it is sensitive/tender.  I sort of noticed it through out the day yesterday when I was scratching my head or running my fingers through my hair but I really started noticing after I washed it and was combing it.  My scalp is slightly itchy but mostly irritated/ red in those spots.  I mentioned that as well when I called.  They said they have not seen an allergic reaction on the scalp with this medication so they think it's related to my seasonal allergies.  They asked me to take pictures and note if it's changing...so there's that.  I would say it is slightly worse from this morning to now but mostly pretty consistent.  It's definitely not any better.

Today was the same as yesterday.  Just doing things here and there but mainly staying in my room.  Today that was mostly because I am starting to feel so sleep deprived.  By about 8pm today, I was starting to feel achy.  My neck and back were getting sore; my head was feeling similar to a sinus headache but my sinuses are clear; and I was just feeling that feverish/hot skin/ dry lips type feeling.  I am not running a fever.  Some of the achiness may be from spending too much time in bed. 🤷 I took an Advil and I am already feeling better.  My stomach finally settled down, I remembered to take a melatonin and I am looking forward to getting some sleep. 🤞

Maybe tomorrow I will make it out of my room long enough to make some brownies.  😋

Sunday, October 20, 2019

Post Lemtrada Day 1 - Rabbit Holes & Germs

Post Lemtrada Day 1

October 20, 2019

Last night my husband started sniffling...he slept in the guest room. 😷😢

This morning I woke up in an odd place of "what now" and semi-self-quarantine.  Contrary to popular belief, I am not a germaphobe; I am germ-conscious. 😏 When the kids were born, I started washing my hands more and carrying hand sanitizer to keep them healthy.  They are teenagers now and it's a habit plus it's a healthy practice.  Now, I feel like I am walking that fine line between cautious and obsessive.  It is very possible my daughter and husband are having allergy attacks.  Our weather, temperature and pressure has been very up and down this week.  My nose has been running a bit this week too; it's possible and it's not like my defenses just disappeared overnight...but...I need to be cautious.  And actually, unless your partner can sleep through a hurricane, they might be more comfortable in another room anyway.  The last two nights I've been up every other hour to go to the bathroom and I am sweating all night.  I am not the most pleasant person to sleep next to right now. 

So...here I am, in this odd place...figuring out my new routine/normal.  Today, I started taking my daily antibiotic (Sulfameth/Trimeth 400-80mg) and a weekly anti-yeast (Fluconazole 150 mg).  I also started a pro-biotic.  Plus I have to continue for at least 30 days all the antihistamines and antacid and will continue the Valcyclovir.  I already have 'pill box' on the shopping list. 😆

I am also trying not to fall down rabbit holes and over think things.  That's another fine line...they tell you not to ignore small things that might become bigger but then you sit and think "did I just feel a pain? is a headache starting?". Or over thinking about what you are eating, "did I heat that up enough?".   It is also not helping that I am sitting in my room avoiding a shared breathing zone with my family!

Two things that are going on that I am going to call the doctor's office about.  My throat is a little sore; I think it's just some drainage from the weather but I want to mention it and also I do have some red spots on my chest.  I got a little too much sun somehow the week before last and my chest has been a little red so I am not sure that's new either but again; I just want to mention it.  

Other than that, I am feeling pretty good.  I didn't sleep great because of all the bathroom trips but I did sleep and I took a 2 hour nap this afternoon.  I am not feeling exhausted but also not very energetic; I just took it easy today.  I did want to sit outside and get some fresh air but melanoma is a possible concern and I have skin cancer in my family so I am not going to push that.  I did go out for a little while after the sun started setting but the mosquitoes quickly found me.  I spent most of the day catching up on things I could do from the computer and listening to an ebook.  I also made sure that I drank plenty of water today; about 70 ounces (total fluids).

Sorry...tangent...I've been listening to the Mr. Rogers autobiography and I highly recommend it.  I saw the movie over the summer which doesn't have nearly the detail of course.  It's really interesting, he studied with people in the late 50s/early 60s who were on the cutting edge of early childhood development and learning...it's really remarkable that he put so much 'science' into his show.

By now you may be thinking that there is "no way you are going to read months of some lady droning on about germs"....do not fear...because most likely I'll have lost interest in this blog by Tuesday anyway 😏 and very soon, probably even after today, I can't see myself posting more then once a week.  I have no idea what the official "rules" are for blog posting frequency but I think weekly would be more than enough.

And I guess that's a wrap for tonight.  I forgot to take melatonin tonight but I am feeling pretty sleepy so here's hoping...

Saturday, October 19, 2019

Infusion Day 5 - LAST DAY

Infusion Day 5

October 19, 2019

I made it!  I am home after my last infusion day and I feel surprisingly good and not as wiped out as I have been at the end of the day.  I assume it's some kind of euphoric relief that this part is over.  I am really trying hard not to be too overly confident about not having any extra reactions to the medication.  They really did pump me up with a TON of anti-histamines, antacid and steroids.  I was reading today that just last year they presented 8 years of data from their very first trials.  So the company has really had a lot of time to dial in a protocol to make medication reactions less frequent and severe.  One of the blogs I read prior to deciding (and again today) was written by a 68-year old man who did his first round of Lemtrada in December 2016.  He said the same thing that he was surprised how easily the week of infusions went and also the first month afterward but in the second month he was hit with a roller coaster of good days and bad days.  He noted that he thinks he pushed himself a little too much right after when he was feeling good and that the 'good feeling' was probably mostly due to all the steroids.  I know I definitely have that in me.  I already have around-the-house projects in mind to do...so yes, I definitely have to be mindful of that.  One of the tips the One-to-One nurse gave me was to not be inactive but to rest and not to wait until I am exhausted first.  Another tip was to continue to drink lots of water. Not only because the medication can have an affect on your kidneys but also you are going to have cell die off and it's better to get all that flushed out instead of letting it settle into your system and cause  discomfort.  I am not a very good hydrator in general so that's another thing I will need to be mindful of.  

I wouldn't have done this in the first place if I hadn't felt confident in the process.  If you read all the warnings on the Lemtrada website or listen to the scary recording they play you on the phone, it makes you think twice.  There is a lot of potential for a lot of serious things to go wrong.  You are more susceptible to thyroid disease and melanoma which I've had one but they are also keeping a super close eye on you.  I have to get monthly blood and urine analysis done for two years after my last infusion; that's four years total if I only do the two annual treatments.  The drug manufacture has a set of tests they run for things that they know can commonly go wrong and since my doctor has been working with this drug for so long, he has his own protocol on top of that.  He checks for additional items that he knows would be early warning signs for issues.  He also tries to ensure your T & B cells come back at a similar pace.  Apparently, there can be issues if they don't so if he sees that; he may give me a medication to knock one back a little.  Plus there is a whole list of warning signs that I should be checking myself for daily.  It gives me confidence that the drug has been in trials for so long and that it was FDA approved.  It gives me even more confidence that my doctor has taken over 100 patients through this process without any serious side effects and that he has such a good handle on what the drug is capable of and how to make it more effective.  Really, that is the big one.  This is a serious drug and I would not want to be my doctor's first patient to take it.

To celebrate, I am in my room eating gluten free super hero chicken nuggets and crinkle cut fries. 🥳 My daughter is sniffle-y; I hope it's just allergies because she just got over a cold 3 weeks ago but I am not taking any chances.  That's all I need in my first week.  Plus my knees were feeling stiff and I wanted to put my feet up.  There you go; I am in here blogging with my feet up and my gourmet dinner in bed and my family is in the living room watching Carrie. 😱 What are you going to do?  
They did all go get flu shots today and brought me chicken and rice soup for lunch so I love them to pieces for that.  It was very cute.  The infusion center doesn't like to have family/friends come hang out because it's an open area and there is the chance to over hear medical information but they let them come back to bring me my lunch and they all flashed me their Walgreens band-aids on their shoulders. 😍

The day went really smoothly again.  I did have to get another IV started since I decided to take out the second one yesterday.  She ended up having to try twice because the first vein didn't want to cooperate but the vein she did get was a lot more comfortable so I am glad I did it.  My poor left arm is a little bruised up but it will survive.  The Pecid infusion and the steroid infusion went pretty quickly.  Just when they were switching me over from the steroid to the Lemtrada, my head started feeling a little weird like I was a little light headed.  I did mention it to the nurse because that is one thing they stress is not to ignore anything that might seem small because it could be the start of an allergic reaction but at this point I wasn't even on the Lemtrada yet so I thought maybe I was getting tired but again I wanted to mention it.  I also thought maybe it was my blood pressure but that was fine; I got up to use the bathroom and it actually felt a little better.  I just noticed it for a while; it didn't get worse and eventually did get better.  I stayed awake for most of the day today.  I reviewed my information about what to do and look for after the infusions.  Tomorrow, I have to start my antibiotic.  I also wrote an email that really should not have taken me that long but ended up taking me most of the day because I was getting up and down to use the bathroom every 30 minutes for a little while.  After the Lemtrada was done, I did close my eyes and listened to an ebook for the last couple hours.  

I was able to snag my back corner recliner again today which made me happy.  It was definitely the best spot to be since I was there all day and had a bigger bag. My first infusion day, I had to be there at 8:30 but every other day I was there at 9:30.  Today, when we walked in there were two other people in the waiting room.  I sat down and started bouncing my knee in nervousness about getting my spot.  When the nurse called me back only a few minutes later which actually felt like 10; I told her "I think the steroids are really getting to me because I was sitting there getting worked up about my spot."  I was also freaking out a bit more about having any air in the IV line.  I know a little is ok and it just dissolves in your blood but man that's a creepy feeling watching it move toward your vein.  I couldn't help but feel like I was a little bit more of a pain in the ass today but they were all so nice there; I don't think they would have told me anyway and I am pretty sure they could appreciate how much steroid I was on.  I tried really hard to be as friendly as possible.  For the most part this week, I was pretty quiet.

I think I've gone on long enough for tonight and I am getting tired but one other thing I was thinking about today and noticed all week watching people come and go.  Infusion medications are a huge business; I had no idea.  That's all they do at that center.  There are no cancer patients going there.  I didn't talk to a lot of people but I did talk to two briefly and both had different autoimmune diseases and the treatment they were getting was for that.  I knew that there were three different types of infusion medications for MS.  One of them was taken off the market for a little while but I just didn't realize the extent of it.  The only other time I was ever in an infusion center was for that steroid in 2013 and I was only there for a couple hours for 3 days, I didn't really pay attention to what other people were doing.  I mentioned that I thought the Evoke Potential tests where a bit medieval feeling; this feels very futuristic to me.  It just reminds me of medical scenes in space movies.  Everyone hooked up to a bag of something....seems crazy but maybe that is my half cooked brain on steroids and antihistamines. 🙊

That's it for tonight...tomorrow starts Phase 3, I guess?
Phase I - Vaccines/Prep
Phase II - First Infusion
Phase III - Recovery part 1 (yep phase 3, it is)

Friday, October 18, 2019

Infusion Day 4

Infusion Day 4

October 18, 2019

Tomorrow is my last day...I am in the homestretch now.

Last night I laid in bed with my legs raised while I finished my blog post.  When I got up to get ready for bed, I noticed my knees felt a lot better.  So the stiffness is definitely due to fluid retention in my legs that's actually a good thing.  Now, I know I need to get my feet up instead of trying to loosen my knees up by walking more.

The 5mg of melatonin was enough to get me off to sleep.  I was a little worried at first because I did lay there wake for awhile but I was asleep in about a half hour and when I woke up to use the bathroom I was less groggy but still able to get back to sleep; it seemed to work well.  I am going to take 5mg again tonight.

As I sit here now, I have about an hour left on my Lemtrada infusion.  Yesterday, the nurse moved my IV out just a bit and re-taped it to see if that helped the sensitivity.  It helped for sure but it's still a little pinch-y/stingy here and there; I am going to have them take it out before I leave tonight.  I've got a little bit of a bruise on my wrist right above where the two IVs were.  I did notice that there was a really light bruise on Tuesday but today it's just a little darker.  My knuckles are getting dried and cracking from all the bathroom trips/handwashing.  I put some aquiphor on them last night.  I started checking more thoroughly for any changes in my skin or lumps in my lymph nodes; I haven't noticed anything.  My skin still has more color but it's not yellowing; it's just from my blood pressure being a little higher.  

My blood pressure started out a little higher than it has been; 125/69 but it also went down to 95/70 which is more normal for me.  It's mostly been in the 115-120 (top number) range today.  I noticed yesterday that it doesn't take much to get my heart rate up right now.  I was moving around the house "quickly" yesterday morning.  I say it in quotes because I was just moving a little faster than my normal.  My heart didn't start racing but I did notice it picked up.  This morning the routine was a little different, my husband had to take my son to an appointment and a friend drove me to the infusion center.  After everyone had left, I had about an hour before I was being picked up and I suddenly got very anxious.  I was trying to get my bag and snacks together and suddenly just felt hot and needed to sit down.  I sat on the couch and slowed my breathing down. I sat quietly for about 10 minutes then did some chair yoga, pranayama breathing and a short meditation.  It definitely helped quiet everything down.  I mentioned the episode to the nurse and she said that could be another steroid reaction; anxiety and being emotional are typical reactions.  I've experienced panic attacks before and this wasn't rising to that level but it felt like it could have moved in that direction.  The nurse just recommended keeping an eye on it.

As a whole today went very smoothly again and I was extremely sleepy for most of the day again too.  I don't think I really fell asleep but I had a hard time keeping my eyes open for several hours in the middle of the day. My mouth has been very dry today but there are two other factors at play there.  I am wearing Invisalign trays right now and for some reason just having that plastic in your mouth really makes your mouth dry and because I have the Invisalign, I have been very diligent about washing them with antiseptic mouthwash and rinsing my mouth with mouthwash twice a day.  I don't want to add any bacteria potential.  I have the Listerine 'Naturals' but it still has alcohol in it which dries your mouth out.

After finishing four days, I have some tips for making the process more comfortable.  My goal in doing this is to be helpful for someone who may be deciding to do this medication.  I am a pretty private person so this is really out of my comfort zone to share so much publicly. 

Infusion Survival Tips:

1. Don't be afraid to pack what you need.  You might feel funny walking into the infusion center with a travel bag but you are going to be there for 8 hours.  Most patients are only there for an hour or two.  On Monday, I listed everything I packed and I have felt it has all been helpful. I've been a little too tired to read so bringing things to listen to as well is very helpful.

2. Make a plan for lunches.  Since you need to be careful about Listeria contamination (Jimmy John's super freaky fast delivery won't be your friend this week); it's really helpful to have an idea of how you are going to get lunch and what you might want to eat.  Whether delivered by a friend or delivery service or if you are going to bring your own.  You can bring raw veggies and fruit for yourself but you need to make sure you've washed everything at home to ensure it's safe.

3. If you need special snacks like gluten free, bring them yourself.  This infusion center as I am sure most have plenty of snacks; just not ones for special diets.

4. Bring some Aquiphor or something similar for your hands.  You will be going to the bathroom and washing your hands ALOT.  They want you to drink lots of water because this medication can affect your kidney so flushing it is important and they will be giving you two bags of Saline fluids too.

5. Do whatever you can to keep yourself calm this week.  You will be getting a lot of steroids that will rev your system up.  Don't look at news or stressful work projects or whatever tends to get you tense. The meds are doing enough work on you.

6. Have someone drive you to and home from the infusion center.  Originally, I was going to drive myself but by the end of the day I've been so drowsy that it wouldn't have been safe for me to drive.  I am really glad we decided to have my husband drive me.

This isn't related to the infusion center but I was talking to someone today and realized that it would be a really good idea to have your whole family get a flu shot, especially if you have school aged kids.  We normally don't get the flu shot for three reasons:
1. The conspiracy theorist in me wonders why they push the flu shot so hard. 😼
2. I don't like that they use mercury as the preservative.
3. We are pretty lucky and don't normally get the flu. *knock on wood*
Saying all that though, I personally have been getting the flu shot for myself the last several years and clearly for these next two years, it's pretty important to do anything you can to protect yourself from extra germ exposure.

Well, that's about all I have in me for today.  I hope some of this was helpful.

Thursday, October 17, 2019

Infusion Day 3

Infusion Day 3

October 17, 2019

Almost a wrap on day 3.  I've got about 30 more minutes until I can go.  I had planned to start typing this up this morning then finish this afternoon but I was really tired and unmotivated today.

I was able to get some sleep last night; taking the melatonin really helped.  I did take 10mg like my doctor's office suggested.  I was asleep by 10:30 and slept until about 5:30, although I did lay in bed until 7 (my alarm was set for 7).  Not a completely restful sleep unfortunately, I woke up at least 3 times to use the bathroom and I was sweating every time.  I am in my forties so I am not completely unfamiliar with night sweats but this was obviously due to the steroids too.  Still, I'll take it versus staring at the wall for hours thinking about how 'Texas Constitutional Amendment 4" is poorly worded and confusing and I need to warn voters. Because that's what any decent person thinks about at 3 in the morning. 😉

The stiffness in my knees was gone in the morning and the swelling in my legs was down.  As I am sitting here, I can tell that the stiffness is coming back though.  I did get a call back from a One-to-One nurse last night and they really couldn't help me much because they didn't have anything in their "system" about swelling or stiffness. 🙄 For context; the company that makes Lemtrada has a nurse-line program called One-to-One.  You are assigned a nurse who takes you through the process and answers any of your questions and they have a 24/7 call line; it's actually nice and helpful but they have limitations because they are not your doctor.  Now, I am more familiar with their limitations.

I am still doing really well overall.  Things I have noticed: still running hotter than my normal.  My blood pressure (top number) was in the 112-120 range today.  Two of my readings were 121/55 and 114/61.  I feel warm and sometimes flush on my face but not running a fever.  My knees are stiff again and legs a little swollen but not any more then yesterday.  I am home now so I have my legs raised above my heart.  My new IV must be close to a nerve because I was getting a stinging sensation sometimes when the vein was being flushed or a new infusion bag was started and sometimes for no particular reason.  I decided to keep it because it wasn't constant but I think I will have to have it taken out after tomorrow.  I was really sleepy and warn down as I mentioned earlier.  I mostly listened to an audio book and drifted in and out of sleep.

I mentioned the morning medicine routine and the Lamatrada infusion routine but I am also keeping up with my same everyday vitamin routine.  After I eat lunch, I 've been taking the Valcyclovir aka horse pill; a Vitamin C, Vitamin B and Zinc (those are my typical vitamins).  After an hour or two, I've been taking a cranberry concentrate that is new and was recommended to combat bladder infections.  With dinner, I take a Vitamin K2 and Magnesium and at bedtime I take Vitamin D drops and my LDN; again I was taking these before as my regular routine.

The infusion center I've been going to clearly has a good hiring and training process.  All the nurses there are super patient and friendly.  Most of them are younger (as in younger than me) and I've seen them with some more difficult patients.  Difficult meaning either the patient themselves are particular or maybe they just have a harder time finding an accessible vein.  Today, my husband had mid-day meetings and wasn't able to bring lunch up to me.  The nurse who was helping me today, microwaved the frozen dinner I brought with me and brought it out to me with a plate and fork.  I so appreciated that.

I guess that's about it for today.  I already took 5mg of melatonin; hopefully that will be enough to get me off to sleep but not so much that I am bouncing off walls in the middle of the night to get to the bathroom. 😳 Oh, I did email my doctor about the stiff and swollen knees.  I didn't feel it warranted a phone call but I haven't heard back yet.  I did find out that A. they don't recommend drinking herbal teas for at least 3 months after and B. I can and should take a pro-biotic while I am taking the antibiotic (for 3 months after my last infusion day).  I feel like I had some of these things written down. I guess I better go back through my notes. 

Wednesday, October 16, 2019

Infusion Day 2

October 16, 2019

Infusion Day 2

Previously...on Amy's Lemtrada infusion...  

I had to throw that in there so everyone knows I know the difference between pervious and previous.
My husband has pointed out a few typos.  Sorry about that.

Just quickly: the morning routine at home was the same.  I took my thyroid pill; ate breakfast; did some easy yoga stretches and breathing (I wasn't having any issues with the IV they left in but I didn't want to put any pressure on that arm either).  Before we left I took: Ranitidine (antacid) , Hydroxyzine (allergy med) and Cetirizine (allergy med).

Overall, I am feeling good.  I didn't have any allergic reactions to the infusion yesterday.  However, I have full blown insomnia 😟, side effect of the steroids.  I was on steroid pills for the 7 days prior.  I was having some sleeping issues but now it's been two nights in a row with less than 3 hours of sleep each.  I emailed my Neurology PA to see what I can do.  I'll be on this steroid all 5 days.
Oh, and I've changed my opinion of using steroids for an energy boost.  By Saturday I was retaining so much water, I looked four months pregnant! Not worth the trade off.  😉

Going into this process,  I was expecting an allergic reaction at the infusion site (itching/rash) and to feel like I have the flu the following week as those seemed to be the most common issues other people experienced.  All the medications you are given with the Lemtrada seem to be geared toward lessening those reactions.  Everything they give you is to lower your body inflammation.  I am trying to help that process by keeping my inflammation low with yoga and eating.  I am purposely picturing the medicine calming my body down and healing it instead of fighting against it or killing off cells (which it is actually doing).  Eating at the moment is hard anyway.  Since my immune system is going offline I need to be extra careful about Listeria and other bacteria in foods.  I can't just get a deli sandwich. Things need to be cooked well.  Eating takes planning/thought and I am trying to stay away from inflammatory foods such as gluten and dairy which I know inflame my system.  The grilled cheese I had yesterday was gluten free and vegan. 😋 I usually drink green juice to help with  inflammation but for now it'll have to be the grocery store pasteurized versions.  I can't have smoothies or raw juices unless I make them at home and I know that everything has been fully washed.  It's not worth the risk.  That is my goal/mission: keep my body calm so the medication can do its job as easily as possible and hopefully I can lessen the reactions and "fight".

Each of the five days at the infusion center will be the same.  When I arrive they give me Benadryl and Ibuprofen in pill form.  Then I get one infusion bag of Pepcid and one infusion bag of steroid (Solu-Medrol 1g). After that they start the Lemtrada with a bag of saline to dilute it.  All of that takes about 5.5 hours.  Then they observe you for 2 hours.  The first hour you get another saline bag and the second you just sit and relax.  

Currently, I am sitting through my last saline bag and should be leaving in about an hour.  I was able to use the same IV as yesterday with no problem.  I am going to have them take it out though so I can take a full shower and sleep without worrying about it.  My doctor recommend taking 10mg of Melatonin about 3 hours before I go to bed which will basically be as soon as I get home. 
Also, my IV is feeling a little tender and pinch-y.  Not bad but once in a while it feels like I can feel the medicine; that probably doesn't really make sense but it's definitely getting sensitive.

It was recommended to me to drink lots of fluids.  I don't remember how much exactly but between water and juice I drank about 54 ounces so far today. Plus the saline solution so there are quite a few trips to the bathroom and it's kind of a pain wheeling your IV stand around people.  It does get busy in here in the late morning/early afternoon.  Right now I am closing the place down though. 🥳  

A couple other observations from today.  I was running a little hot all day which is a side effect of the steroids.  In general, I tend to be cold and I have low blood pressure.  I never remember the bottom number but my top number typically runs from 95-102 and can go as low as 90.  Today, my upper number was in the range of 105-115.  This is still really low but just a little elevated for me.  My skin also has more color than normal. Temporary bonus.

 Oh, the younger man that I noticed yesterday.  He was here when I first arrived and my husband got him to talk a bit.  Unfortunately, he was having some type reaction so he left for some testing.  Obviously, I have no idea what other issues he had but I felt bad for him.  I asked my nurse about how many Lemtrada patients they see because I was under the impression it was rare and insurance didn't approve it that often but apparently they have been seeing it more often.  The in-take nurse also mentioned it was just approved by the FDA two years ago so apparently it's been under development for a long time because I know it's been around for 10.  The recent approval is probably making it more frequent as well.

Well, I am almost done here.  Two days down and three to go.

Update: 8:00 pm - When I got home this evening I noticed my knees are pretty stiff and my legs look like they are retaining water particularly around my knees.  Both things seem reasonable to me since I just spent two days in a recliner all day and I've had a lot of fluids but I did leave an after hours message for a One-to-One Nurse just to confirm. 

Tuesday, October 15, 2019

Infusion Day 1

Lemtrada Infusion Day 1


This morning we arrived at the infusion center at 8:20 to start paperwork.  This week I haven't been as nervous as I had been the previous 6 months since deciding to do Lemtrada but this morning the nervous energy was FLOWING.  I barely slept last night; I may have gotten 3 hours, maybe.  I had a hard time failing asleep then staying asleep.  I felt like I heard every little sound.

When I got up, I took my thyroid medicine; did some yoga stretches and meditation breathing. Maybe those of you who are 70s and 80s babies might remember a book call "Six Months to Live".  I remember reading it in class in fourth grade.  It's about a thirteen year old girl who gets leukemia. There is a part in the book when they tell the kids to imagine the chemo working in their body and she used the visualization of a Teddy Bear Army killing off the cancer.  Obviously, that stuck with me.  Anyway, along those lines I was letting myself picture the medicine as a glow; not fighting my cells but smoothly coating them and healing them.  I pictured my cells glowing with health. 
After, I ate; took my antacid, and two allergy pills; made lunch for the kids; fed the dog; added my son's slides to my bag...we were out the door.

I filled out what felt like a ton of paperwork, we met with the in-take nurse to get my vitals, go over my paperwork and answer any questions.  Then we made our way into the infusion area to pick a seat.  They gave me some Benadryl and Ibuprofen and within 30 minutes, I was officially hooked up:


The first bag was another Pepcid/antacid; the next was a steroid.  Both went quickly without an issue. I am sensitive to liquids in my veins.  Meaning, I can always 'smell' when they put saline solution in my IV between medications so the steroids did give me a weird 'taste' in my mouth but they had warned me about that; I just drank some apple juice and sucked on a Jolly Rancher.  It helped a little.  It went away within 30 minutes after I was done with the steroid.

Next was the Lemtrada with a bag of saline solution to keep me hydrated and to dilute the medication.  They checked my blood pressure every 15 minutes for the first hour and then periodically after that.




And yes, the fuzzy socks are a definite must!

Was I a little over packed?  Yes but my husband couldn't stay with me during the infusion because it's an open room and they have security/confidentiality protocol for necessary reasons.  
I had plenty to keep myself occupied.  I sent texts to family and friends; posted on Instagram which I don't usually use for that type of thing;  and played candy crush.  I was too tired to read so I watched a couple episodes of 'The Good Place'. I just needed something light and mindless and that fit.  Not sure how they got 4 seasons out of that show?  I made it through two episodes then got drowsy so I just listen to some meditation music, did my visualization and relaxed.  

They are pretty stocked here with snacks, candy and drinks but not many gluten free so I am glad I brought things for myself.  I had a Luna Bar and a packet of apple sauce before lunch and I ate my gluten free chocolate fudge pretzels after. Everyone needs a treat. 😋

My husband brought me soup and a grilled cheese sandwich around 2.  After I ate, I took Valcyclovir (herpes med that I will take now and for two years; looks like a horse pill 😝); my Vyvanse, Vitamin C, Vitamin B, and Zinc.  About 20 minutes later my heart was beating faster; maybe it's not a good idea to take the Vyvanse while I am doing the infusion. I have enough flowing through me that can raise my blood pressure.  I mentioned it to the nurse but it must not have been that big of an issue; she agreed that maybe the Vyvanse at this time wasn't a good idea. 

I finished my Lemtrada around 3pm and now I am just on a Saline solution while they observe me for two hours.  I'll be finished by 5.  The guy who was sitting across from me just left.  I noticed he was doing Lemtrada too.  Odd coincidence, I didn't think it was a very common treatment.  It seemed to be his first day too.  I wanted to ask him who his doctor was etc but he didn't seem to be a talker and I didn't want to pry.  He seemed a little younger than me too.

So all around, it's been a fine first day.  My IV isn't bothering me so I am just going to keep it for tomorrow.  I'll try to do a quick update this evening.

Update: 9:00pm.  Doing fine no signs of reactions.  Just very tired with a slight headache.

Monday, October 14, 2019

Pre-Lemtrada Day 7

October 14, 2019

Pre-Lemtrada Day 7

Tomorrow is the day.  Bright and early I start at 8:30am.  I've got my free Victoria Secret travel bag packed.  
I packed:
-  iPad loaded with the Netflix app, 2 ebooks, 1 audiobook and candy crush.
- phone with music loaded
- laptop in case I want to blog or email.  I rather type longer notes on a keyboard.
- Doctor Who blanket
- sweatshirt
- comfy socks
- baseball hat
- 2 pouches of apple sauce
- gluten free chocolate covered pretzels
- 2 small bottles of apple juice
- a reusable water bottle
- mints
- ear buds, head phones, chargers
- Kleenex, hand sanitizer, lip balm



Today was the second day on both of the allergy meds and acid reflux med plus my last day on the steroid pills.  I still felt pretty light headed this morning and took a nap for about an hour.

I tried to take it easy today but I still managed to do a last curbside grocery pick-up; cleaned out the fridge; got myself packed up; made my medication list (which is a mile long now); completed my absentee ballot (because you still have to vote); baked some muffins and made dinner. Plus that nap.

Now I am going to bed because I am beat.  🤞 For tomorrow.

Sunday, October 13, 2019

Pre-Lemtrada Day 6

October 13, 2019

Pre-Lemtrada Day 6

I am now 48 hours out until I start my first infusion.
Last night wasn't a great night.  I didn't eat a whole lot on Saturday.  I went to bed late because I was typing up my Background post but I was hungry so I ate a Luna bar before I went to bed. Then I took a Magnesium and Zinc tablet.  I must not have had enough in my stomach because I woke up at 3am having a dream about not eating enough and being nauseous.  I got up and went into the kitchen to eat some cereal.  I smelled the trash and ran to the bathroom to throw up.  Obviously, there wasn't anything there.  I threw up once and waited for my body to calm down then I went back to the kitchen, ate some cereal and went back to bed.  I had set my alarm for 8:30 because my medication said to specifically start taking it 48 hours before my first infusion (I am a rule follower).  When my alarm went off my stomach felt better but not great.  I take a thyroid pill in the morning and you are supposed to wait an hour before eating anything.  I just waited 30 minutes this morning.  I couldn't wait any longer.  

That's what I did; took the thyroid; waited 30 minutes then I ate some oatmeal and took the rest of my pills.  I took Ranitidine 150mg for acid reflux (I'll take this for 30 days); Cetirizine 10mg for allergy (I'll take this for 30 days); and Hydroxyzine Hcl 50mg for inching and anxiety (I'll take this for 30 days).  Plus I have two more days of the steroids left.  Both the Cetirizine and Hydroxyzine cause drowsiness.  My husband made pancakes and bacon; I ate and went back to sleep.  I slept for another 3.5 hours.  I've also been drowsy and light headed most of the day.  I hope I get used to this because I don't want to be a zombie for 30 days.  I did some laundry today but mainly just rested and ate!

It's already past 11 and I don't think I can keep my eyes open any longer plus I think this is enough information for today. 😁

Background - My Journey here

I am thinking maybe some context on how I got here might be appropriate.  If you don't care, just skip this one.  Especially, if you are tired because this ended up longer than I thought it would.

In November 2004, I was 6 months out from having my second baby.  I had my kids 18 months apart so I had spent the majority of the previous 3 years pregnant and/or breastfeeding.  I had just started doing yoga again and I was feeling numbness in my groin area and in both of my legs.  I thought I must have pinched a nerve or tweaked something while doing yoga.  It past in about a week and I didn't think anything else about it.  A few months later in February (2005), I noticed a stronger numbness in my groin area which spread to my legs making my skin feel like it had 'fallen asleep'; down to my feet then by the weekend up my stomach area and to my arms.  When I started to feel tingling in my fingers, I decided it was time to go see a doctor.  It was the weekend so I went to a clinic.  The doctor did some strength testing and poking me with a needle to test my sensation.  I was convinced it was a pinched nerve but he didn't agree.  He suggested I see my regular doctor on Monday which I did. My regular Dr did the same testing and agreed that he didn't think it was a pinched nerve; he sent me to get a MRI.  I had a brain and spine MRI with and without contrast.  This was my first and it seemed like I was in there forever. I didn't have any lesions on my brain but had a very large one on my spine.  I was sent to see a neurologist.

The neurologist pointed out that the lesion on my spine was causing my numbness and diagnosed me right then with MS.  I instantly thought this guy was a quack.  I was a healthy person.  I just had two healthy pregnancies and very healthy babies.  I wasn't a super healthy eater but I wasn't eating fast food everyday; I could have been doing more cardio but I did yoga.  Plus no one in my family had MS.  I needed a second opinion; I was sent to a MS Clinic at Wayne State University in Detroit.

There they told me the different tests I could do.  One of which was a spinal fluid test which I wanted to avoid at all costs.  I had delivered both of my kids without an epidural.  Just out of fear of having a needle put in my spine; I did NOT want to go down that road here.  They ran some blood tests to rule out things like Lyme disease, Devics and Lupus.  I didn't have any of those markers.  Then they sent me to have Evoke Potential tests.  Those are the tests where they give you a stimulus and measure how long it takes for the messages to be sent through your nerves.  I remember doing four of them total over two days.  During each of them they had sensors on my head, arms and legs.  In the first one, I watched a TV screen with a black and white checker board that flashed and switched the squares from black to white. The second one was a clicking sound in my ears.  The third and fourth were electric stimulus on my thumb and big toe that made my thumb and toe twitch.  Thinking about those tests now, laying on a table while my toe or thumb were twitching; seem a little medieval.  After two days and hours of testing; they came back normal.... 😞

My last option was the lumbar puncture aka spinal tap.  😖 By this time, it was around August of 2005.  I did the procedure and it ended up as bad as I had feared.  I developed a spinal leak which left me unable to stand up straight without getting nauseous and my head felt like it weighted 50 pounds.  I couldn't even sit up at the dinner table long enough to eat dinner.  Keep in mind that I had a 1- and a 2-1/2- year old at this time.  My neurologist at the clinic was out of town and the office wasn't much help for some reason; they let me go a week like that.  I ended up in the local ER to get a 'blood patch'.  They take some of your blood and put it in your spinal fluid to patch the leak.  It works so fast it's unbelievable and I had felt bad for so long, it was a relief.  The downside is that the iron in your blood causes back pain while it's breaking down in your spinal fluid.  After all of that...the results came back 'abnormal' but not 'MS abnormal'.  I was told normal is one band and MS 'normal' was three bands but I had two.  All of that for nothing.  I was told that they would do another MRI in December which would be almost a year since my first and they would see me after that.

During all of this, my baby turned one;  I had to go back to work at least part-time and I was having one symptom after another.  My husband worked locally at this time (he started traveling for work the next year) but was part of an IT support desk so could work odd hours.  Luckily, my husband's grandparents were young for great-grandparents and helped us out with the kids during the day and we had other family who lived close by too.  I don't know how we would have made it through without them.  I remember the highlights of this year but everything else is a blur.  During the time between February and December of 2005, I had an itching sensation that felt like it was inside my arm; the skin on one of my sides got really sensitive; and I lost sight in half of my right eye.  I first noticed the eye because my depth perception seemed off and when I closed my left eye, I realized the bottom half of my right eye was cloudy.  Plus I had another relapse sensation in my legs.  Each time it took about 3 months for these things to clear up and some of them were on top of each other.  It was a scary time.  I didn't know why these things were happening but every time I would have a new symptom I would look it up online and it would be a MS symptom.  Even though my spinal fluid test was inconclusive by the time October rolled around, I already knew I had to have MS.

We also knew by this time that the only medications available were shots that had a lot of side effects and honestly weren't that effective.  I wasn't really interested in that and my husband didn't really like the idea either.  Being the expert researcher he is 🤓 he went to work finding out what other options there were.  He found a book called the "The Multiple Sclerosis Diet Book" by a Dr. Swank that was originally published in 1972 and updated later in '77 and '87.  This was a time when there were no medications or much of anything for MS.  Doctors would basically give you the news and tell you "good luck".  Dr. Swank found by putting his patients on a low saturated fat diet, they had less relapses and less progression over time.  I started following the diet around November 2005 and the activity in my relapses slowed down significantly.

I had another MRI in December and met with my neurologist at Wayne State in January.  I now had lesions on my brain and he was comfortable with officially diagnosing me with MS.  I tell people I was officially diagnosed in January of 2006 but that I've had it since November of 2004 and I've known since the fall of 2005.

My husband had kept his researching going and found something called LDN - Low Dose Naltrexone.  There was a lot of anecdotal information out there about it helping all kinds of autoimmune diseases.  There wasn't much hard information/ data so doctors weren't prescribing it because it's considered off label.  We ended up buying it online and I started taking it around February, 2006.  We did a lot of reading online and bought a book called "Up a Creek with a Paddle" written by a women whose husband had progressive MS and LDN had helped him.  I started dissolving the 50mg pills in 50ml of distilled water and taking 4.5 ml of the liquid at night.  I saw another improvement/slow down in my relapses and some increase in my energy.  Some people report odd dreams/nightmares and/or just trouble sleeping.  I didn't have any issues.  I finally felt like I was getting some control after the scary previous year.  I also bought another diet book in the fall of 2006 called the "Gold Coast Cure" by Ivy Larson and her husband.  She has MS and used Dr. Swank's diet but also added in more whole foods and had great results.  I was feeling better and messing around with my diet; taking out dairy and gluten.  We as a family made the switch from dairy milk to almond milk.  I even went vegetarian for awhile but I just wasn't eating enough of a variety and didn't have enough energy.  I had started exercising more at this point and I was starting to get tired and not able to finish my workouts.  I also started doing things like taking more Vitamin D and fish oil.  Fish oil and Vitamin D were noted in the Dr. Swank book as having some notable influence on the prevalence of MS based on research looking at which parts of the world had more incidents of MS.

We moved to Texas in 2009.  I was having issues with seasonal depression during the winter months and because Vitamin D is a big deal when it comes to MS; I figured if I could move south and give my kids a better chance of not developing MS, I would do it.  It has been a good move.  I went over a year after we moved here without a relapse.

Overall, I have been really stable since that first year.  I've continued with just the LDN and my diet.  I started getting the LDN prescribed to me after we moved to Texas.  Although, I am not always as strict with my diet at times.  I've had two major relapses since that very first one in 2005.  The first was around August of 2013, my legs and especially my feet got extremely numb.  My feet were so numb that I was hobbling around and limping like a 90-year old.  During that relapse my husband and I went to a concert, he dropped me off at the door so I wouldn't have to walk.  I was wearing flip-flops and lost one.  I had walked at least five steps away before I looked down and realized I had lost my shoe.  That's how numb my feet were.  I couldn't even feel the warmth of the sidewalk or the texture!   I ended up getting 3 days of a steroid infusion which helped it subside faster.

My second major relapse was in early 2015.  I was working full time at this point and my job was really stressful.  I hadn't realized that stress brought on relapses for me until then because I had never really been this stressed out.  In February, I had some numbness and by March I was realizing that my concentration and focus was being affected.  I didn't always drive to work; I tried to take the bus as much as possible but when I did, I parked in a parking garage and I rubbed my bumper on the wall near the ticket window.  I had also bumped into a couple curbs at other times.  The final straw was when I missed a deadline at work but not because I didn't have enough time to do it; I didn't even remember having a deadline.  I had known something was off but I was trying to power through it.  After I missed that deadline, I asked for a medical leave.  I ended up taking three weeks off just to decompress and get my head back together.  Also at this time, my husband and brother-in-law were about to take a major step with the business they had started and we realized that A) my stress level with my job was not going to get better.  I had already gone from 40-hours to 30-hours per week and B) our lives were about to get a whole lot busier with the expansion of the business.  I did go back to work but only for another two months and then I left in May.

We've been lucky that the business really took off and I didn't have to go back to work.  That wasn't the initial intent but it ended up working out that way.  The business keeps my husband busy more than full time and our kids were moving into middle school and now high school so it just made sense.  It's definitely helped me not to have the added stress to my life.

After my cognitive relapse in 2015, I bought a book called the "The Walhs Protocol" by Dr. Terry Wahls.  Another diet and exercise/life style change book.  Dr. Wahls has MS and was progressing fast and in a wheel chair.  She was able to reverse her progression and start to ride a bike again by changing her diet to a version of a Paleo diet and some life style changes.  Her muscles were so weak that she used e-stimulation to get her muscle tone back and she made some changes around stress in her life.  I did the diet very strictly for a good four months and I felt really great.  Then summer rolled around and I fell off the wagon.  She recommends eating some meat, a variety of it but really emphasizes colored vegetables (3 cups); sulphur vegetables (3 cups) and greens (3 cups) every day.  That can be a lot of work and a lot of eating.  I do what I can and just try to make better choices all around.

Other smaller progressions that I've had. I started getting tingling in my finger tips once in a while.  The first time it happened we actually thought it might be carpal tunnel. That started around 2014.  In February 2013, I ran a half marathon. I had spent all of 2012 training for it.  I had planned to keep running and had trained for a 10 mile run in Austin the following year but a week before my knee went weak on me and I couldn't do it.  I stopped running because it was just too frustrating to train for something then not be able to do it.  Sometime in 2014, I started getting a 'warning shot' when a relapse was coming on.  I would wake up in the morning, stand up and it would take my legs a couple minutes to want to move.  They would shake a little and maybe it was a bit of spasticity.  Because sometimes they would almost feel bouncy, I couldn't really control it and it was only when I first got up.  The rest of the day was fine.  It seems like it would start, I would have some other type of relapse like numbness; the numbness would go away usually quickly and the leg thing would slowly go away.  At some point, I did start a symptom tracker because I wanted to see how I was progressing.  Sometimes you wave away these things as minor but when you look at the whole picture, you realize maybe you're not doing as well as you thought.

During this whole time I was seeing a neurologist (I had two in Texas), typically once a year sometimes for larger stretches because I didn't have much going on.  Both thought overall I was doing as well as I would have been doing taking the shots.  When the two larger relapses happened, my neurologist would bring up other medications.  The shots had gotten better and then there was an oral medication but I just didn't think they would be any better then what I was doing so I never did it.

That leads me to now.  My second Texas neurologist retired on me too. A brain MRI I had done for hearing loss found I had active lesions so my primary Dr wanted me to follow-up with a neurologist.  Now, I have a neurologist who specializes in MS for the first time since we moved to Texas (10 years ago already!) and he said. "You are doing good but I want to keep you good and this is the best way I know how".  My husband and I took in all the things I've been through and realized maybe it's time to do something else.  I've been lucky but I've also had MS for almost 15 years now.  No one knows how many lesions are too many and what pushes you from RRMS (Relapse Remitting) to SPMS (Secondary Progressive).  They just know that every year after 10 years it gets more and more likely.

I don't even know how I got MS in the first place or really what side of the family it came from.  My family on my paternal grandfather's side has skin cancer.  Almost all of us including my grandfather have had abnormal moles, Basel cell skin cancer and I have had a melanoma.  But not really autoimmune diseases.  My maternal grandmother and all her sisters had thyroid issues as they got older and my grandmother also had rheumatoid arthritis as she got older and my mom does now.  I know those are autoimmune diseases but they also just happen when you get older so I am not sure that is really related.

Anyway, I do feel like this medication is extreme but I am hoping it will reboot my system so that I no longer have this flaw in my immune system and I want to use the knowledge I have for eating and general self-care to make sure I don't develop it again.  I am also trying hard to make sure my kids never do.